Supporting Patients With Untreated Prostate Cancer on Active Surveillance: What Causes an Increase in Anxiety During the First 10 Months?
BackgroundThe psychological burden possibly deriving from not immediately undergoing radical treatment for prostate cancer (PCa) could be a potential disadvantage of active surveillance (AS), especially in the eve of some relevant clinical exams [i.e., re-biopsy, prostate-specific antigen (PSA) test...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-11-01
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| Series: | Frontiers in Psychology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyg.2020.576459/full |
| _version_ | 1829141813064105984 |
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| author | Maria Francesca Alvisi Paola Dordoni Tiziana Rancati Barbara Avuzzi Nicola Nicolai Fabio Badenchini Letizia De Luca Tiziana Magnani Cristina Marenghi Julia Menichetti Villa Silvia Zollo Fabiana Salvioni Roberto Valdagni Riccardo Valdagni Riccardo Valdagni Riccardo Bellardita Lara the Prostate Cancer Multidisciplinary Clinic Working Group |
| author_facet | Maria Francesca Alvisi Paola Dordoni Tiziana Rancati Barbara Avuzzi Nicola Nicolai Fabio Badenchini Letizia De Luca Tiziana Magnani Cristina Marenghi Julia Menichetti Villa Silvia Zollo Fabiana Salvioni Roberto Valdagni Riccardo Valdagni Riccardo Valdagni Riccardo Bellardita Lara the Prostate Cancer Multidisciplinary Clinic Working Group |
| author_sort | Maria Francesca Alvisi |
| collection | DOAJ |
| description | BackgroundThe psychological burden possibly deriving from not immediately undergoing radical treatment for prostate cancer (PCa) could be a potential disadvantage of active surveillance (AS), especially in the eve of some relevant clinical exams [i.e., re-biopsy, prostate-specific antigen (PSA) test, and medical examination]. Even if it is known from the literature that the majority of PCa men in AS do not report heightened anxiety, there is a minority of patients who show clinically significant levels of anxiety after diagnosis. The present study aimed to investigate if demographic, clinical, and psychological variables at the entrance in AS (T0) were associated with the risk of developing clinically significant PCa-related anxiety 2 months before the first re-biopsy (T1) and to offer psychological support to improve quality of life (QoL).Materials and MethodsA total of 236 patients participated in the PCa Research International: AS (PRIAS) protocol and in PRIAS-QoL study. Demographic/clinical features, health-related QoL domains, coping with cancer, PCa-related anxiety [Memorial Anxiety Scale for PCa (MAX-PC)], personality traits, and decision-making-related factors were assessed at T0. MAX-PC was also administered at T1. PCa-related anxiety at T1 was considered to be of clinical significance if the MAX-PC score was ≥1.5. Multivariable logistic regression coupled to bootstrap was used to detect factors associated with high levels of anxiety.ResultsThe median age was 64.4 years. Fifty-six patients (24%) reported MAX-PC total score above the cutoff. Three factors were associated with a high level of PCa anxiety at T1: anxious preoccupation [odds ratio (OR) = 4.36], extraversion (OR = 1.9), and prostate-related symptoms (median OR = 0.46). Physical well-being was associated with a low PCa anxiety subscale (median OR = 0.15); neuroticism and functional well-being were associated with PSA anxiety (median OR = 7.05 and 0.73, respectively). Neuroticism and helplessness/hopelessness were associated with fear of progression (median OR = 18.1 and 5.8, respectively).ConclusionOnly a partial portion of the sample experienced significant levels of anxiety after 10 months. Psychological assessment should be routinely conducted to detect risk factors (i.e., anxious preoccupation, extraversion) for increased anxiety, offering tailored psychological interventions aimed at promoting interpersonal awareness and emotional well-being. |
| first_indexed | 2024-12-14T20:20:56Z |
| format | Article |
| id | doaj.art-c0e8f0b5761c4d57bd189b7e86453c4c |
| institution | Directory Open Access Journal |
| issn | 1664-1078 |
| language | English |
| last_indexed | 2024-12-14T20:20:56Z |
| publishDate | 2020-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychology |
| spelling | doaj.art-c0e8f0b5761c4d57bd189b7e86453c4c2022-12-21T22:48:44ZengFrontiers Media S.A.Frontiers in Psychology1664-10782020-11-011110.3389/fpsyg.2020.576459576459Supporting Patients With Untreated Prostate Cancer on Active Surveillance: What Causes an Increase in Anxiety During the First 10 Months?Maria Francesca Alvisi0Paola Dordoni1Tiziana Rancati2Barbara Avuzzi3Nicola Nicolai4Fabio Badenchini5Letizia De Luca6Tiziana Magnani7Cristina Marenghi8Julia Menichetti9Villa Silvia10Zollo Fabiana11Salvioni Roberto12Valdagni Riccardo13Valdagni Riccardo14Valdagni Riccardo15Bellardita Lara16the Prostate Cancer Multidisciplinary Clinic Working GroupProstate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyProstate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyProstate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyRadiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyDepartment of Urology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyProstate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyProstate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyProstate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyProstate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyProstate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyProstate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyProstate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyDepartment of Urology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyDepartment of Oncology and Hemato-Oncology, University of Milan, Milan, ItalyProstate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyRadiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyProstate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyBackgroundThe psychological burden possibly deriving from not immediately undergoing radical treatment for prostate cancer (PCa) could be a potential disadvantage of active surveillance (AS), especially in the eve of some relevant clinical exams [i.e., re-biopsy, prostate-specific antigen (PSA) test, and medical examination]. Even if it is known from the literature that the majority of PCa men in AS do not report heightened anxiety, there is a minority of patients who show clinically significant levels of anxiety after diagnosis. The present study aimed to investigate if demographic, clinical, and psychological variables at the entrance in AS (T0) were associated with the risk of developing clinically significant PCa-related anxiety 2 months before the first re-biopsy (T1) and to offer psychological support to improve quality of life (QoL).Materials and MethodsA total of 236 patients participated in the PCa Research International: AS (PRIAS) protocol and in PRIAS-QoL study. Demographic/clinical features, health-related QoL domains, coping with cancer, PCa-related anxiety [Memorial Anxiety Scale for PCa (MAX-PC)], personality traits, and decision-making-related factors were assessed at T0. MAX-PC was also administered at T1. PCa-related anxiety at T1 was considered to be of clinical significance if the MAX-PC score was ≥1.5. Multivariable logistic regression coupled to bootstrap was used to detect factors associated with high levels of anxiety.ResultsThe median age was 64.4 years. Fifty-six patients (24%) reported MAX-PC total score above the cutoff. Three factors were associated with a high level of PCa anxiety at T1: anxious preoccupation [odds ratio (OR) = 4.36], extraversion (OR = 1.9), and prostate-related symptoms (median OR = 0.46). Physical well-being was associated with a low PCa anxiety subscale (median OR = 0.15); neuroticism and functional well-being were associated with PSA anxiety (median OR = 7.05 and 0.73, respectively). Neuroticism and helplessness/hopelessness were associated with fear of progression (median OR = 18.1 and 5.8, respectively).ConclusionOnly a partial portion of the sample experienced significant levels of anxiety after 10 months. Psychological assessment should be routinely conducted to detect risk factors (i.e., anxious preoccupation, extraversion) for increased anxiety, offering tailored psychological interventions aimed at promoting interpersonal awareness and emotional well-being.https://www.frontiersin.org/articles/10.3389/fpsyg.2020.576459/fullanxietyactive surveillanceprostate cancercoping strategiespersonality traits |
| spellingShingle | Maria Francesca Alvisi Paola Dordoni Tiziana Rancati Barbara Avuzzi Nicola Nicolai Fabio Badenchini Letizia De Luca Tiziana Magnani Cristina Marenghi Julia Menichetti Villa Silvia Zollo Fabiana Salvioni Roberto Valdagni Riccardo Valdagni Riccardo Valdagni Riccardo Bellardita Lara the Prostate Cancer Multidisciplinary Clinic Working Group Supporting Patients With Untreated Prostate Cancer on Active Surveillance: What Causes an Increase in Anxiety During the First 10 Months? Frontiers in Psychology anxiety active surveillance prostate cancer coping strategies personality traits |
| title | Supporting Patients With Untreated Prostate Cancer on Active Surveillance: What Causes an Increase in Anxiety During the First 10 Months? |
| title_full | Supporting Patients With Untreated Prostate Cancer on Active Surveillance: What Causes an Increase in Anxiety During the First 10 Months? |
| title_fullStr | Supporting Patients With Untreated Prostate Cancer on Active Surveillance: What Causes an Increase in Anxiety During the First 10 Months? |
| title_full_unstemmed | Supporting Patients With Untreated Prostate Cancer on Active Surveillance: What Causes an Increase in Anxiety During the First 10 Months? |
| title_short | Supporting Patients With Untreated Prostate Cancer on Active Surveillance: What Causes an Increase in Anxiety During the First 10 Months? |
| title_sort | supporting patients with untreated prostate cancer on active surveillance what causes an increase in anxiety during the first 10 months |
| topic | anxiety active surveillance prostate cancer coping strategies personality traits |
| url | https://www.frontiersin.org/articles/10.3389/fpsyg.2020.576459/full |
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